The cost of management of complications from diabetes in the USA amounted to US$263 billion (about £171 billion) in 2013, up from $92 billion (about £60 billion) in 2002. More than half of the growth in the costs of diabetes care can be attributed to prescription drugs such as insulin, the price of which has increased at alarming rates for both patients and insurers.

Using state Medicaid data, we recently noted that inflation-adjusted expenditures have increased on a per-unit basis for all commercially available insulin since 1991.